Management of Radiation Necrosis and Advanced Cancer of the Chest Wall in Patients with Breast Malignancy

Woods, Jan E.; Arnold, Phillip G.; Masson, James K.; Irons, George B.; Payne, W. Spencer

doi:10.1097/00006534-197902000-00013

Cited by 15 publications

(6 citation statements)

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“…1 In our patient, although the first debridement appeared sufficient to eradicate the infection, it failed to do so, probably because of microscopic residue of the infectious focus, and the poor blood supply caused by radical mastectomy and radiation. 1 In our patient, although the first debridement appeared sufficient to eradicate the infection, it failed to do so, probably because of microscopic residue of the infectious focus, and the poor blood supply caused by radical mastectomy and radiation.…”

Section: Discussionmentioning

confidence: 56%

Untitled

2002

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We report herein the case of a patient who initially underwent right radical mastectomy for breast carcinoma in 1988, followed by left breast-conserving surgery in 1997. On both occasions she was given postoperative radiation therapy of 50 Gy. Repeated dressings and the administration of antibiotics failed to heal ulcerative infected lesions that had formed on the anterior chest wall in early 1998. In 1999, the sternum and surrounding tissue were debrided and the anterior chest wall was reconstructed by omentum transposition and mesh skin grafting. The patient is currently well and alive without any evidence of recurrence of either infection or breast cancer.

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Section: Discussionmentioning

confidence: 56%

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2002

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“…They are rarely used for reconstruction of the large chest wall defects due to potential for necrosis and delayed wound healing 2 . The literature usually focuses on case series (2-29 cases) involving fasciocutaneous and thoracoepigastric flaps for chest wall reconstruction 3,[13][14][15][16] . The degree of elevation of the flap depends on the size of the chest wall defect.…”

Section: B B a Amentioning

confidence: 99%

“…The degree of elevation of the flap depends on the size of the chest wall defect. These studies defined vertical boundary as the mammary fold and the second intercostal space and horizontal boundary as the middle axillary line and the middle sternal line 3,[13][14][15][16] . Anatomic boundaries of tumor resection were more extended in our cases than ones in the previous studies, thus, required more dissection with larger sized flaps.…”

Section: B B a Amentioning

confidence: 99%

“…Anatomic boundaries of tumor resection were more extended in our cases than ones in the previous studies, thus, required more dissection with larger sized flaps. Previous reports defined the anterior axillary line as the end of the axial pattern of the flap 3,[13][14][15][16] . Thoracoepigastric flaps were more like random flaps with diminished vasculature, if it extended toward the posterior axillary line.…”

Section: B B a Amentioning

confidence: 99%

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Manejo de la necrosis del colgajo toracoepigástrico en pacientes con cáncer de mama

Şimşek¹

2021

CIRU

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“…In the last year, 12 patients have undergone extensive chest wall resection. Eight patients had recurrent cancer after prior resection and irradiation with an average defect of 160 square centimeters, usually including ribs and a portion of the sternum; four had radionacrosis of soft tissue and/or bone.…”

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confidence: 99%

Major chest wall reconstruction after chest wall irradiation

Larson

McMurtrey

Howe

et al. 1982

Cancer

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In the last year, 12 patients have undergone extensive chest wall resection. Eight patients had recurrent cancer after prior resection and irradiation with an average defect of 160 square centimeters, usually including ribs and a portion of the sternum; four had radionecrosis of soft tissue and/or bone. Methods of reconstruction included latissimus dorsi musculocutaneous (MC) flap (five patients), pectoralis major MC flap (seven patients), and omental flap and skin graft (one patient). The donor site was usually closed primarily. All flaps survived providing good wound coverage. The only complication was partial loss of a latissimus dorsi MC flap related to an infected wound; this reconstruction was salvaged with a pectoralis major MC flap. The hospital stay ranged from 10-25 days with a median stay of 11 days. Use of the MC flap is a valuable tool which can be used to significantly decrease morbidity, hospital stay, and patient discomfort related to the difficult problem of chest wall reconstruction after radiation therapy.

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Management of Radiation Necrosis and Advanced Cancer of the Chest Wall in Patients with Breast Malignancy

Cited by 15 publications

References 0 publications

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Manejo de la necrosis del colgajo toracoepigástrico en pacientes con cáncer de mama

Major chest wall reconstruction after chest wall irradiation

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